A Case of Eosinophilic Otitis Media Implanted with Bone-Anchored Hearing Aid

Abstract

Eosinophilic otitis media (EOM) is characterized by the presence of highly viscous middle ear effusion containing eosinophils, and is usually associated with bronchial asthma. Intratympanic corticosteroid administration and/or systemic steroid administration are effective treatments. However, the middle ear effusion and progressive hearing loss are difficult to control, significantly affecting the patient’s quality of life. Therefore, appropriate care is important not only for controlling the middle ear effusion and otorrhea, but also for preventing the progression of hearing loss.A 46-year-old woman was referred to our hospital with suspected eosinophilic otitis media. She had a history of asthma and aspirin sensitivity. In addition, she had recurrent nasal polyps despite having undergone nasal polypectomy on two occasions. She was diagnosed as having bilateral EOM according to the diagnostic criteria. She was started on steroid treatment, but after showing initial response, the middle ear effusion recurred immediately after withdrawal of steroid treatment. Although the patient also had difficulty in communication because of bilateral hearing loss, she could not wear hearing aids because of the middle ear effusion. Hearing aids sometimes aggravate middle ear infection by blocking aeration, increasing the risk of sensorineural hearing loss. Therefore, we implanted a bone-anchored hearing aid (Baha®) in her right ear. Average hearing threshold of 500, 1000 and 2000 was 35 dB using Baha®. Although audiometry revealed deterioration of the bone-conduction threshold in the right ear at five years after the Baha® implantation, she still had sufficient bone conduction hearing using Baha® because of the preserved bone-conduction in the contralateral ear. The Baha® hearing system is a clinically effective and good hearing rehabilitative device for patients with EOM.